Continuity of care and health decline associated with a hip fracture.

Objectives: Identify determinants of health decline associated with hip fracture with the goal of designing interventions.

Method: Prefracture and postfracture information was obtained from participants aged 65-plus years fracturing a hip between July 1996 and August 1997. Health utilization data were linked to the cohort data and to an age-gender matched cohort of nonfracture seniors.

Results: Fracture patients were likely to have been hospitalized and have low continuity of care. Patients making frequent physician visits were at increased risk of both prefracture hospitalization and postfracture health decline. Prefracture hospitalization was less likely for patients with high physical function; patients of high mental status were less likely to experience postfracture health decline.

Discussion: Health appears to be in decline prefracture. Patients may benefit from continuous physician care to prevent further health deterioration. Some hip fractures can be prevented by identifying high-risk seniors at an early stage and intervening to prevent falls.